Minnesotans are kinder to their hearts: study

NEW YORK (Reuters Health) - Minnesotans are less likely than the average American to die of heart disease, and lower rates of risk factors like smoking and high blood pressure may help explain why, a new study finds.

While the U.S. death rate from heart disease has dropped by nearly half in recent decades, Minnesota still beats the rest of the country with only about two in 1,000 residents dying from heart attacks, strokes and similar conditions in 2005.

The question has been why.

For the new study, reported in the American Journal of Epidemiology, researchers compared data from a long-running federal health survey of U.S. adults with a long-term study of heart health among people living in the Minneapolis-St. Paul area.

Compared with the U.S. norm, Minnesota adults consistently smoked less, had lower blood pressure and cholesterol levels, and maintained trimmer waistlines in the past few decades.

"The lower rate of risk factors seems to explain part of" the difference in heart disease deaths, said Dr. Lyn M. Steffen, an associate professor of epidemiology at the University of Minnesota in Minneapolis and one of the researchers on the study.

Between 1980 and 2002, 47 percent of Minnesota women had none of four major risk factors for heart disease -- obesity, current smoking, high blood pressure and high cholesterol. That compared with 36 percent of U.S. women overall.

Among men, 44 percent of Minnesotans had none of the risk factors, versus only 34 percent of men nationally.

At the same time, death rates from heart disease fell both nationally and in Minnesota, but the state maintained its better numbers.

In 1980, 322 per 100,000 men in the Twin Cities area died due to clogged blood vessels in the heart, versus 346 per 100,000 nationally. By 2005, those rates had fallen to 89 deaths per 100,000 men in Minnesota, and 135 per 100,000 nationwide.

Similarly, the 1980 rate among women in the area was 102 per 100,000, versus 120 per 100,000 nationally. In 2005, just 29 out of every 100,000 Minnesotan women died of heart disease, compared with 53 per 100,000 nationally.

That's not the whole story, she noted in an interview -- and factors like healthcare quality are probably key. In the Minnesota study, about 95 percent of people had healthcare coverage, compared with 80 to 85 percent of Americans in the national study.

That means not smoking, getting regular exercise and, if necessary, using medication to treat high blood pressure and high cholesterol.

Steffen put extra emphasis on diet.

"People need to pay attention to the whole diet," she said. "Get plenty of fruits, vegetables and whole grains. And we need to pay attention to calories."

Indeed, while studies suggest that Americans' smoking levels, cholesterol, blood pressure and exercise habits have improved since 1980, one problem that has steadily gotten worse is the obesity rate.

In this study, Minnesotans managed to keep trimmer waistlines than the rest of the U.S. But the overall picture was bleak: by 2002, 43 percent of Minnesota participants had abdominal obesity, as did 59 percent of the national study group.

Overall calorie intake also increased in both study groups over time, Steffen noted.

She suggested that people pay more attention to their portion sizes and the calorie content of the foods they eat. She also advised against simply reaching for low-fat packaged foods, which are often high in sugar and salt to make up for the lost fat content.